Colostomy appliance



July 25, 1950 J.. H. JOLLY 2,516,391.

COLOSTOMY APPLIANCE, I

Filed Jan. 6, 1949- 2 shuts-sneeze INVISNTOR. Jesse Earner .faZQ

Patented July 25, 1950 UNITED STATES PATENT OFFICE 'COLOSTOMY APPLIANCE I Jesse Homer Jolly, Cincinnati, 1.0hio

Application January 6, 1949, Serial No..69,498

1'2 Claims.

1 The present invention relates to .a colostomy appliance, adapted for use by persons-who'have, of necessity, undergone a colostomyoperation, in

which the colon has been removed, in whole or in part, and, as. a result, the lower end of the small intestine has been left protruding externally through an incision in the lower abdomen. Although such operations have becomequite common in recent years, and remarkable recoveries havebeenmadeby persons who have undergone the same, considerable discomfort and inconvenience have been 'suiiered by such persons, through the inefiiciency and inefiectiveness-of the appliances used'to cover the above mentioned incision; to enclose and prote'ct'the protruding end of the small'intestine, andto'receive' the digested food discharged therefrom. "Of course, the patient has substantially no control'over'such discharge and "littl or no control over-the degree of projection of'the end of'the'small'intestine from the incision.

The primary object of the present invention is to provide an improved appliance for'covering the incision, andfor'receiving the protruding end of the small intestine; and, in'combination with such an appliance, to provide an'improved'recep tacle for receiving the discharge.

Another object of .the invention is to provide such an appliance with'adjustable features,'which will vary the effective size of'the'discharge spaces or openingsfromthe device; and will" limit the degreeoi projection of theendbf the intestine from the 'incision,'so th-at,depen'ding upon'the activity of'the wearer and his position, such as lying pronegsittingpor moving about, "the appliance may be adjusted for maximum eificiency and comfort. To 'this end; the appliancemay'be adjusted from a fully open position, to permit relatively unrestricted -"discharge'from"the device, when the wearerisirrbed, to'a' position somewhat restricting the discharge,"iorinstance when'ithe wearer" is moving about-walking, or exercising.

"Another object of'the invention isto'provide an appliance or the kind described in-whi'ch this adjustment-may be readily 'efiected, without-removing the appliance-from the body.

A Other and further obj ects and advantages of theinvention will be'apparent' from the following description of apreferred embodimenh'shown for purposes of illustration "in the-accompanying drawings, in-w-hich:

Figure 1- is a diagrammaticelevational view-of the appliance-applied to" the bodyof a-user;

Figure 2 is a vertical section and -partialside elevation of"Figure 1,'-onanenlarged scale;

Figure 3 is a front elevation, on an enlarged scale, showing the appliance removed from the bodyand with the sack removed;

'Figure liis a section on line 4-4 of Fig-ure 3;

'-Figure-5 is a fragmentary sectionon-line 5 5 of Figure3, and

fFigureG isan elevation'of a clamping ring for securing the sack to the appliance.

The appliance I'll-may besecured to the abdomen ofthe user, by a belt ll, encircling the hips or waist and connected to the appliance as hereinafter explained. The appliance comprises an inner plate l2, which is preferablymade of a transparent plastic, such as "a methyl methacryllateresinyhaving a central aperture 13 therein, through which the protruding end Id of the'small intestine may project, in relatively snugly fitting-relation. Asbest shown inF-igures 3-5, the appliance further comprises an outer, imperforate plate 15, of similar material, spaced from the innerplate by a plurality of circumferentially spaced-webmembers1B, ll, l8,'and l9, fixedly secured to the-plates. As shown in Figure 3, the radially inner edges 20' of the web members l 6 and IT extend "inwardly beyond the margin of the central aperture "E3 or beyond acylindrical projection of said margin, while the webmembers l8 and 19-may bespaced-radially outwardly from themargin of the aperture.

Interposed between'the fixed web members area plurality of movable members 2!, 22, 23, and 2 l,-which, in the preferred embodiment, takes the 'form'of wings spanning the space between the inner and outer plates and each mounted, oficenter, on 'apin Zi, 'journalled for rotation in the upper and lower plates. The pins may be constituted by screws or bolts, having slotted heads 25, with a -metallic washer 26 and af-riction producing'fiuid-tight, rubber Washer 21 interposed between each head and the outersurface oithe plate -15. A-clamping nut 28- and a ioc-k-nut-z-fimay be threaded on the shanks of the screws, below theupperplate l 5. Each Wing may comprise a generally L-shaped element having a leg-portiondil,through-which the screw124 extends and to which'it is secured, for instanceby a locking pin 3!. -Each-wing also-comprises an upwardly extending, 1 body portion -32, disposed laterally with respect to'the-first mentioned portion, -and-projectingradially outwardly from the pivoting axis of screw '24 a substantial distance.

The wing members and the fixed web members are preferably made of the same material as the inner and outerplates.

By turning the pivot-screws 24, for instance,

amen

3 by inserting a coin in the kerf in the heads 25, the wing members may be swung from the outer position, shown in dotted lines in Figure 3 in which they are spaced outwardly beyond the margin of the aperture [3, to an inner position, shown in full lines, in which their effective end edges 33 project inwardly beyond said margin. When in the former position, the full size of the aperture 13 is eifective and the spaces between the wings and fixed members are increased in size, for the free flow of material therethrough. However, the degree of projection of the end of the intestine is limited by the outer plate l5 and, laterally, by the fixed and movable members. When the movable members are in the inner position, however, the eifective size of the opening 13 is reduced and the degree of lateral projection of the end of the intestine is materially limited. Similarly, the discharge of matter from the appliance as a whole is unrestricted or restricted,

depending upon the position of the movable members.

Upon the outer surface of the plate l5, there are molded or otherwise secured, a plurality of lugs 35, 36, 31, and 38, projecting laterally beyond the outer margin of the plate and providing notches 39, for the reception of a contractible metallic ring 40 (Fig. 2) and the marginal portion of an aperture in the outer ply of the upper, head portion 4| of a sack 42. The head portion of the sack has a rear ply 43 lying behind the inner plate 12 and provided with an. aperture M, registering with the plate aperture l3 and through which the end M of the intestine may project.

The sack is preferably formed from a single piece of rubber, rubberized fabric or the like, folded along the upper edge, at 45, to provide the rear ply 43, mentioned above, and a front ply 46. The piece of material is shaped, as indicated, to provide the laterally elongated head portion M, which may extend along the waistline, below the belt II, and a pair of depending receptacles 4'1 and 48, which extend downwardly along the thighs of the user. The margins 49, 59, and iii are provided with a fluid tight seam, while the lower ends of the depending portions are unsecured, to facilitate cleaning, but are normally closed by spring clips 52 and 53.

The contractible metal ring 48 is provided with a tightening screw 54, threaded in a nut carried adjacent one end of the ring and free to turn in a non-threaded aperture in the other outwardly turned end. The first mentioned end is extended to a point underlying the outwardly turned end, to prevent pinching of the sack as the ring is contracted. Thus, by tightening the ring, the portion of the outer ply adjacent the margin of the opening therein, is tightly clamped against the circumferential edge of the outer plate Hi. The ring 40 has secured to it, two pairs of lugs or buttons 55, 56, 57, 58, which project through appropriate openings in the ends of the belt I I. Also, the ring carries a downwardly projecting arm Ell, having a button 6| on its lower end, to which is attached one end of a strap at, extending below the crotch of the wearer, and connected to the belt at a bacl; portion thereof. This rigid arm and strap are important, to prevent the appliance as a whole from swinging upwardly under the pull of the belt, and to maintain the inner plate l2 firmly in contact with the body of the user. The leverage provided by the arm 69 is quite effective for this purpose.

It is thought that the manner of use of the combination of the present invention will be apparent from a consideration of the foregoing description. When the user is reclining, for instance when he has retired for the night, the movable wings may be shifted to their outermost positions, thereby increasing the size of the spaces between the fixed and movable members, thereby facilitating the discharge of digested food from the appliance, even in the absence of the effect of the force of gravity, which is much more pronounced when the user is standing erect or sitting down. This condition is conducive to comfort when the person is reclining and facilitates the natural discharge of digested food.

On the other hand, when the wearer is active, as when walking about, the pressure of the organs within the body tends to force the end of the intestine outwardly through the incision, to an undue extent. To counteract this tendency, the wings are swung to their inwardly projected positions, in which they limit the extent to which the end of the intestine can project outwardly from the incision, thereby materially contributing to P the comfort and well being of the wearer when walking about, while still permitting the discharge from the appliance, through the spaces adjacent the wings, of digested food under the influence of gravity.

The wings may also be shifted to their outer positions when desired, should the appliance become clogged as a result of an excessive discharge or surge of material, which sometimes occurs when food is eaten which is difiicult to digest. The shifting of the wings, on these occasions, permits the free passage of material and enables the appliance to flush itself.

The invention is not limited to the details of construction shown in the accompanying drawings and described above, but includes all modifications coming within the scope of the appended claims and their equivalents.

I claim:

1. A colostomy appliance comprising an inner plate having a central aperture adapted to receive the projecting end of the small intestine, an imperforate outer plate, a plurality. offixed, spaced apart members connected to the inner and outer plates and maintaining the plates in spaced apart relation and a plurality of intermediate members extending between the plates adjacent said aperture, spaced from the fixed member and each movable from a radially outer position in non-obstructing relation to said aperture, to a radially inner position, to vary the effective size of the space between the members, to control the rate of discharge from said ap pliance.

2. A colostomy appliance comprising an inner plate having a central aperture adapted to receive the projecting end of the small intestine, an imperforate outer plate, a plurality of fixed, spaced apart members connected to the inner and outer plates and maintaining the plates in spaced apart relation and a plurality of intermediate wing members extending between the plates adjacent said aperture, spaced from the fixed members and each being movable from a radially outer position, spaced outwardly from I the margin of the aperture, to a radially inwardly plate having a central aperture .adapted to :receive the projecting end of the small :intestine, an :imperforate 9111161 plate, ;:a 1 plurality of fixed, spaced apartmembers connected .to :the inner andiouter plates and maintaining the plates 1 in spaced .apart "relation and a pluralitypf intermediate ,wing members pivotally ,mounted wadjacent the aperture, between :the plates in the spaces between the fixed members, each of said wing members being pivoted ofi center and being swingablefrom an outer position to an inwardly projected position,'to -.vary the effective-size of the spaces between the ,members, to .control the rate of discharge from said appliance.

4. A..colostomy appliancev comprising an inner plate having a central aperture adapted to receive the projecting end of the small intestine, an imperforate outer plate, a plurality of fixed, circumferentially spaced webs connected betweenit'he inner andlonterplates and spacing the same apart, certain of said webs having their inner edges arranged substantially normal to the inner plate and projecting radially inwardly beyond the margin of said aperture, and a plurality of movable webs disposed adjacent said aperture, between the fixed webs, secured to the inner and outer plates and spanning the space therebetween, said movable webs being movable from an outer position, disposed radially out wardly of the margin of said aperture, to an inner position, projecting radially inwardly beyond said margin, said movable web in the last mentioned position cooperating with the first men-- tioned fixed webs to reduce the eifective size of the spaces between the webs.

5. An appliance in accordance with claim 3, in which means are provided on the outer surface of the outer plate for moving said wings.

6. A colostomy appliance comprising an inner plate having a central aperture adapted to re ceive the projecting end of the small intestine, an imperforate outer plate, a plurality of fixed, circumferentially spaced web connected between the inner and outer plates and spacing the same apart, certain of said webs having their inner edges arranged substantially normal to the inner plate and projecting radially inwardly beyond the margin of said aperture, and a plurality of wings disposed in spaced relation between the fixed webs and each pivoted off center between the inner and outer plates adjacent said aper ture, said wing being swingable from an outer position in which they are disposed outwardly of the margins of the aperture to an inner position in which they project inwardly beyond the margin of said opening to reduce the effective size of the spaces between the webs.

'7. A colostomy appliance comprising an inner plate having a central aperture adapted to receive the projecting end of the small intestine, an imperforate outer plate, a plurality of fixed, circumferentially spaced webs connected between the inner and outer plates and spacing the same apart, certain of said webs having their inner edges arranged substantially normal to the inner plate and projecting radially inwardly beyond the margin of said aperture, a plurality of wings disposed adajacent said aperture in spaced rela tion between the fixed webs, a corresponding plurality of pivot pins to which the wings are attached, extending through the outer plate, means on the outer ends of said pins for swinging the wings from an outer position in which they are disposed outwardly of the margins of the aperture to an inner position in which they project reduce the efiective size of ,thespaces between:

hewebs. H I M 8. A colostomy appfance comprising aninner plate havin a central aperture-adapted .to re-' ceive'the'projecting end of the small intestine, an imperforate outer plate, a plurality of movable members ,arranged circumferentially in spaced relation adjacent to said aperture and extending between the plates, and means disposed on the outerisurface-of the outer plate for moving said members from a radially outer position, inwhich they are disposed outwardly of the margin of said aperture, to a radially inwardly projecting position, in which they extend radially inwardly beyond the margin of the aperture.

9. A colostomy appliance comprising an inner plate shaving ca central, aperture adapted to re ceive the projecting end of .thesmall intestine, an :imperforate outer plate, a plurality of. pivot ally mounted members arranged circumferentially in :spaced .relation adjacent to said aper ture and extending between the plates," and means disposed on the outer surface of the outer plate for swinging said members from a radially outer position, in which they are disposed outwardly of the margin of said aperture, to a radially inwardly projecting position, in which they extend radially inwardly beyond the margin of the aperture.

10. In combination a colostomy appliance adapted to limit the degree of projection of the protruding end of the small intestine and to receive the discharge therefrom and a sack for receiving said discharge from the appliance, said appliance comprising an inner plate having a central aperture to receive said end, an imperforate outer plate, a plurality of circumferentially spaced, fixed members connecting the inner and outer plates and spacing the same apart, and a plurality of movable, intermediate members adj acent said aperture, spaced from the fixed members and each being movable from a radially outer position to a radially inner position, without closing the spaces between the members and the fixed members and leaving the peripheral space between the plates unobstructed, said members in the inner position serving to reduce the effective size of said aperture and said spaces to reduce the discharge therefrom, said sack comprising a depending portion and a head portion circumferentially embracing said peripheral space between the plates, to receive discharge therefrom, and means for securing said head portion to the inner and outer plates in fluid tight relation.

11. The combination of claim 10, characterized in that the head portion of said sack has an apertured part lying behind the inner plate with the aperture therein registering with the central aperture in the inner plate.

12. The combination of claim 10 characterized in that the head portion of the sack fitted upon the appliance leaves the central portion of the outer plate exposed to view, and in that the outer plate is made of transparent plastic material.

13. The combination of claim 10 characterized in that the head portion of the sack has a rear ply provided with an aperture registering with the aperture in the inner plate and has an outer ply provided with an enlarged aperture, the marginal portion of which is clamped to the edge of the outer plate.

14. In combination, a colostomy appliance and a seek for receiving the discharge therefrom,said appliance comprising an'inner plate having an opening adapted to receive the projecting end of the small intestine, an outer imperforate plate, means spaced circumferentiallyabout said opening, spacing the plates apart and permitting substantially free discharge of materialcircumferentially through the space between the plates, while limiting the extent of projection of said end through the opening, a sack having a folded upper portion providing an inner ply disposed behind the inner plate, having an aperture therein registering with said opening in the inner plate, and an outer ply having an opening therein with the margin thereof secured to a marginal portion of the outer plate, and a pair of depending portions communicating interiorly with said upper portion and being adapted to lie against the thighs of the wearer.

15. The combination of claim 1% characterized in that the margin of the aperture in the outer ply of the upper portion of thesack is 1'7. The combination of claim 14 characterized in that the margin of the aperture in the outer ply of the upper portion of the sack is clamped upon the edge of the outer plate by a contractible ring, in that the ring carries means for attaching the same to a waist encircling belt, and in that the ring carries a rigid, downwardly extending arm for attachmentto a strap adapted to extend below the crotch of the wearer for securement to said belt at the rear thereof.

JESSE HOMER JOLLY.

.7 No references cited. 

